title: Branched-chain amino acids to tyrosine ratio (BTR) predicts intrahepatic distant recurrence and survival for early hepatocellular carcinoma.
abstract: OBJECTIVE
  The Child-Pugh classification system is the most widely used system for assessing hepatic functional reserve in HCC treatment. In the Child-Pugh classification system, serum albumin levels are used to accurately assess the status of protein metabolism and nutrition. To date, a lack of attention has been given to amino acid metabolism. In the present study, we investigated whether the branched-chain amino acids to tyrosine ratio (BTR) as an indicator of amino acid metabolism can serve as both a prognostic factor for early HCC and a predictive factor for recurrence.
  
  
  METHODS
  We conducted a cohort study of 50 patients with stage I/II HCC enrolled between May 2002 and December 2010. It was investigated whether BTR can serve as both a prognostic factor and a predictive factor for HCC recurrence.
  
  
  RESULTS
  Overall survival rates were significantly higher in patients with high baseline BTR than in those with low BTR. Multivariate analysis showed that both BTR and serum albumin were prognostic factors, and that BTR was the best predictive factor for recurrence.
  
  
  CONCLUSIONS
  BTR was a prognostic factor for early HCC and the most predictive factor for intrahepatic distant recurrence and contributing factors for survival.
authors.forename: Toru
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Kubota
authors.forename: Ryoko
authors.initials: R
authors.lastname: Horigome
authors.forename: Naruhiro
authors.initials: N
authors.lastname: Kimura
authors.forename: Hiroki
authors.initials: H
authors.lastname: Honda
authors.forename: Akito
authors.initials: A
authors.lastname: Iwanaga
authors.forename: Keiichi
authors.initials: K
authors.lastname: Seki
authors.forename: Terasu
authors.initials: T
authors.lastname: Honma
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Yoshida
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000597:Amino Acids, Branched-Chain / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis; D000075462:Serum Albumin, Human; D015996:Survival Rate; D013997:Time Factors; D014443:Tyrosine / Q000097:blood*
chemical_list: C422455:ALB protein, human; D000597:Amino Acids, Branched-Chain; D014408:Biomarkers, Tumor; D012709:Serum Albumin; D014443:Tyrosine; D000075462:Serum Albumin, Human